Skip to main content
2024 AANS Annual Scientific Meeting Main banner
Back

Comparing Open and Closed Cell Stents in Idiopathic Intracranial Hypertension: A Comprehensive Meta-Analysis of Clinical Outcomes

Friday, May 3, 2024

    Presenting Author(s)

  • Marcio Yuri Ferreira, MD

    Research Collaborator
    Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil

    • Co-Author(s)

  • JA

    José Alberto Almeida Filho, MD

    MD
    Department of Neurosurgery, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil, United States

  • SB

    Savio Batista, n/a

    Medical Student
    Federal University of Rio de Janeiro
    Rio De Janeiro, Rio de Janeiro, Brazil

  • GM

    Guilherme Melo Silva, n/a

    Medical student
    Faculty of Medicine, Federal University of Rio de Janeiro, United States

  • Lucca B. Palavani

    Medical Student
    Max Planck University Center

  • AP

    Agostinho Pinheiro, n/a

    Doctor
    Department of Neurology, Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA, United States

  • JS

    João Pedro Sanches, n/a

    Medical student
    Federal University of Rio de Janeiro, United States

  • GV

    Gabriel Verly, n/a

    Medical Student
    Federal University of Rio de Janeiro, United States

Introduction: Open cell stents (OC) and closed cell stents (CC), each offer unique advantages and potential drawbacks in the context of Idiopathic Intracranial Hypertension (IIH) treatment. We aim to investigate the safety and efficacy of using OC and CC for IIH.

Methods: We conducted a systematic-review in PubMed, Embase, and Cochrane Library databases following the PRISMA-guidelines. Eligible studies included ≥4 patients with IIH treated by OC or CC. Primary outcomes were headache, visual acuity, and papilledema status before and after the procedure. Additionally, failure-rate, minor-complications, major-complications, and total-complications were assessed. Pooled-analysis of OC group and CC group were done separately and then compared.

Results: 24 studies were included. Of these, 20 reported on OC and 6 reported on CC. Pooled-analysis of failure-rate was 8% (4%-12%) in OC and 5% (0%-11%) CC. For headache improvement rate: 78% (70%-86%) in OC and 81% (66%-69%) in CC. For visual acuity improvement: 78% (65%-92%) in OC and 76% (29%-100%) in CC. For papilledema improvement: 88% (77%-98%) in OC and 82% (67%-98%) in CC. For Minor-complications 0% (0%-1%) in OC and 0% (0%-2%) in CC. Major-complications: 0% (0%-1%) in OC and 2% (0%-6%) in CC. Total-complications: 0% (0%-1%) in OC and 2% (0%-6%) in CC.

Conclusion : Low failure and complication rates were found in both OC and CC, with no significant difference between them in effectiveness. The CC showed a slight but significant increase in major and total-complications compared to the OC. Additionally, a subtle yet significantly lower failure-rate was identified in the CC.